Determinants of ‘good’ work

Having outlined the aspects of work participants felt directly impacted upon their health and wellbeing, this section covers themes relating to the determinants of ‘good’ work, i.e. the psychosocial aspects of work thought to influence employee health-related outcomes.

5.4.3.1. High levels of employee control and an emphasis on creativity

In general, employees reported having a high degree of control over how their work was done. This was true for both high- and low-ranking employees. For example, Participant 7, a female, full-time business advisor at an organisation providing ‘community development’ services, explained how she was able to change aspects of the service they delivered without consulting their manager:

“I can pretty much mould what I’m doing at the moment to how I see fit – if I want to change the way that we deliver work—I just pretty much re-did this workshop today as to how I wanted to deliver even though that’s not how it was generally did because that’s how I think it’s better. If I want to edit the way that I deliver the workshops or take a process with the one-to-ones I might tell my manager but we wouldn’t have to even necessarily consult unless it was a big thing.” (P7; female, 25–44, full-time, micro)

In their role as business advisor, this employee provided advice and support to help people create new businesses. As they point out, they felt able to shape service delivery, in particular how workshops were delivered and often without their manager’s consent – although they admit they might need it for a “big thing”. Nonetheless, they felt they had a significant degree of control over their work. Although it is true this employee was high ranking, and therefore,

arguably, likely to have significant control over their work, participants across organisations and at different levels within them felt the same.

Participant 14, a female part-time worker who had recently joined a small ‘health’ services organisation as a session coordinator, describes the freedom they had in designing and delivering exercises classes:

“it’s good to have that ‘OK this is what you need to achieve, find a creative way of achieving it and report back’, so you know you’ve got an end but it’s cool trying to find your own way” (P14; female, 15–24, part-time, small)

They are told what they need to achieve but not how they should achieve it. This was a common theme. For example, Participant 21, a male, full-time, lower-ranking employee who worked as a development associate, helping the company develop its digital strategy, described their job in similar terms:

“Our job descriptions are to the point enough, but they kind of allow you quite a lot of flexibility in how you interpret that ... you can then use your networks or you can use your interests for example to help do that – so my interests being technology, young carers, schools – that’s why I’ve been able to develop stuff for schools. (P21; male, 25–44, full-time, micro)

Again, these participants have an idea of what they are required to do in their role but freedom in how they go about it. In this particular case, the employee is able to draw on their own personal interests and apply them to their work.

Thus, both higher- and lower-ranking employees seemed to have control over their work. This is significant because control is a key determinant of ‘good’ work (Marmot et al., 2010; NICE, 2015) and a well-established predictor of employee health and wellbeing (Kivimäki & Kawachi, 2015). There are, for example, positive, longitudinal associations between having control and a range of health outcomes, including subjective wellbeing (Stansfeld et al., 2013); job satisfaction (De Lange et al., 2004); self-reported health (Smith, Frank, Bondy & Mustard, 2008); and mental health (Bentley et al., 2015); as well as reduced risk of MSDs (Bugajska et al., 2013). Systematic reviews of intervention studies have also shown the positive mental health impact of increasing employees’ job control (Bambra et al., 2007; Egan et al., 2007; Michie & Williams, 2003). That both higher- and lower-ranking

employees had control is also noteworthy given that the latter tend to report lower levels of control over their work (García-Serrano, 2011; van Wanrooy et al., 2013).

These findings are consistent with existing, limited evidence, from social enterprises in the UK (Addicott, 2011; Aiken, 2006; Bull & Crompton, 2006; Villeneuve-Smith & Temple, 2015), Sweden (Pestoff, 2000), a UK social firm (Svanberg et al., 2010) and Italian social co-operatives (Borzaga & Depedri, 2009; Borzaga & Tortia, 2006), that suggests social enterprise employees have control over their work. On the basis of these qualitative findings, participants seemed to benefit from ‘decision authority’ – one of two domains of control – which is the extent to which an employee can make their own decisions, the freedom they have in decision-making, and how much ‘say’ they have over their job. A recent meta- analysis found that this domain is the more reliable predictor of future mental and physical ill health (Joensuu, 2014).

As discussed, the organisations in this sample were small in size, dedicated to providing ‘services’, including ‘health’, ‘advice’ and ‘community development’. This is important because both organisation size and industry influence how much control employees have over their work, with smaller organisations and those active in the above areas usually offering staff more control (Eurofound, 2012; García-Serrano, 2011; Idson, 1990). Thus, the high levels of control reported by participants may have been determined, at least in part, by these factors. Nevertheless, it is significant that employees at, various levels within organisations, had control over their work.

Generally high levels of employee control were underpinned by a perception that organisations either encouraged or allowed employees to be expressive in their work. For example, Participant 16, a male, full-time health trainer, describes how their organisation embraces this approach:

“Another big thing for me about [the organisation] is that they advocate creativity and that sort of stuff. They let you go out and put your own spin on things, as long as it’s within reason and you’re doing your job, they really do back innovation and that’s really good.” (P16; male, 25–44, full-time, small)

As a health trainer, this employee worked on a one-to-one basis with people in the local community, helping them to make health-enhancing changes to their lives. Rather than dictate what aspects of behaviour change should be achieved or how they should be achieved, the organisation gave the employee freedom in deciding what to do and how to do it, i.e.

“advocate creativity”. A male, full-time community engagement officer from the same organisation echoed these views:

“I’m an ideas person and I’ve been allowed to come up with a lot of ideas here and actually see them through.” (P17; male, 25–44, full-time, small)

Although this participant is not a senior member of staff they are encouraged to think of and implement new ideas. The organisation’s commitment to fostering a culture of creativity is underlined by the comments from a manger working in the same organisation:

“Nobody is watching you and judging with regards to when you come in and when you leave – they want you to be creative in your approach and giving you freedom encourages that.” (P18; female, 45–64, full-time, small)

Thus, there is an effort from management to ensure employees work in an environment that encourages creativity.

Such an approach was not confined to this particular social enterprise. For example, the chief executive of an organisation providing an ‘advice’ service described how employees are encouraged to pursue their own interests and let that feed into their work:

“The ‘Google time’ side of it is that inevitably if people are able to work on things that they genuinely think are awesome things to do, then it tends to make them pretty awesome. Obviously it can’t be something that’s totally tangential to what we’re doing.” (P8; male, 25–44, full-time, micro)

While they are careful to point out that activities pursued must bear some relation to employees’ work, this demonstrates how these organisations back innovation. An employee from this organisation, Participant 17, a male full-time employee, who, as a development associate, worked on the company’s digital strategy, benefitted from this approach:

“He [the chief executive] trusts people that we know what the social mission of what we’re trying to do is … he just lets us get on with it and celebrates all the innovations and the different ways that things morph and change –because you’re empowered to say ‘that doesn’t work – I’m going to change it’ – it’s not like ‘I’ve got to ask my manager’.” (P21; male, 18–24, full-time, micro)

Trust from management, which employees, generally, claimed to have (see Section 5.4.1.1), is integral to this approach. Employees felt empowered to shape their role according to their preferences and skills.

This is significant in the sense that ‘authenticity’ at work, defined as the extent to which an employees’ job “allows them to do what they actually think is meaningful, important and interesting, in a way that fits their own preferences” (van den Bosch & Taris, 2014a, p. 660), has been shown to be associated with improved employee wellbeing. Several cross-sectional studies report positive relationships between authenticity and wellbeing (Ménard & Brunet, 2011; Toor & Ofori, 2009) and job satisfaction (van den Bosch & Taris, 2014b) and negative associations with stress, burnout (van den Bosch & Taris, 2014a) and adverse mental health outcomes such as anxiety and depression (Sheldon et al., 1997; Wood et al., 2008). Although these studies are cross-sectional and therefore do not permit causal inference, a lack of authenticity is thought to influence health via stress pathways: employees lacking freedom to express themselves in their work, being forced to perform tasks they do not value or enjoy, places strain on the worker that could result in stress and negative affect (van den Bosch & Taris, 2014b). Thus, to the extent that the creative culture fostered by these organisations enables employees to be authentic, it may positively impact on employees’ health and wellbeing.

In addition, cross-sectional evidence from 250 supervisory and non-supervisory support university employees suggests that perceived support for creativity at work is associated with increased job satisfaction and reduced stress (Stokols et al., 2002). Furthermore, longitudinal research from a study involving 222 workers employed in the chemicals, high tech, and consumer products industries finds that support for creativity at work is an antecedent of positive affect: when employees’ ideas are welcomed, they may see improvements in self-esteem and self-confidence, for example (Amabile et al., 2005). Additional longitudinal evidence, from the British Household Panel Survey (BHPS), supports this; Dolan & Metcalfe (2012) found that employees moving from other sectors into creative ones registered an improvement in job satisfaction. Thus, these social enterprises’ support for creativity may be a positive influence on employees’ wellbeing.

Generally speaking, the control employees had over their work compared favourably with their previous work experience. For example, a female, full-time employee, Participant 4, worked in a highly skilled role as an educational psychologist at a social enterprise providing an ‘advice’ service. Their job involved identifying children that would benefit from, for example, one-to-one support in the classroom. If a child had a significant level of need

their parents might be entitled to financial support from a local authority. Previously, they had carried out the same role at a local council:

“At [the council] there was a much tighter feel around what the criteria would be for a child to get funding – the threshold seemed a lot higher [than here] and that’s the message I got from my boss ... here I’ve been allowed to do stuff and develop stuff that I perhaps wouldn’t in a local authority so there’s a bit more freedom in that respect ... it did appeal to me because it’s a much more innovative way of working.” (P4; female, 24–44, full-time, micro)

When they worked as an educational psychologist at the council, they did not have the level of freedom to do their job that they have had whilst working in a social enterprise, where they have been able to, for example, develop interventions. They describe this as a more innovative way of working. Indeed, there was a general perception that the public sector, in comparison to social enterprise, was “extremely risk-averse” (P20; male, 25–44, full-time, small) and discouraged creativity:

“They [the organisation] let you spread your wings andthat’s nice whereas with other statutory organisations you’ve got the red tape, the policies and procedures, “this is how it’s done right across the board and that’s it” and there’s no wavering, that’s it and that’s the end of it.” (P16; male, 25–44, full-time, small)

This participant, a male who worked full-time in a lower skilled job as a health trainer, describes how they felt unable to exert any influence on how services were delivered while performing a similar role in a statutory organisation. This contrasts with their experience working in a social enterprise.

Thus, despite performing similar roles in public sector organisations providing similar services, participants felt there was more emphasis on creativity, and room for expression, in social enterprises. It is worth pointing out that public sector organisations would likely be significantly larger than the social enterprises the interviewees worked for, which could, at least in part, influenced the amount of freedom they had, given that (as discussed previously) employee control varies significantly according to organisation size (García-Serrano, 2011; Idson, 1990). In addition, these are the views of people that no longer work in the public sector, which could influence their perception. Nonetheless, it is apparent that participants

reported having a significant amount of control over their work and that this contrasted with their previous work experience in other organisations.

5.4.3.2. A flexible working environment

In addition to reporting high levels of control over how they did their work, participants, in general, claimed to have flexibility regarding when the work was done (temporal flexibility) and where the work was done (spatial flexibility), which is consistent with the limited, existing, evidence available from social enterprises (Krupa et al., 2003; Morrow et al., 2009; Pestoff, 2000, Williams et al., 2012). This was the case for more highly skilled employees, such as Participant 3, a female, part-time, assistant psychologist, and lower skilled employees, such as Participant 12 a female who worked full-time in an administrative role, and Participant 19, a female, full-time community engagement officer. Participant 12 explained how the organisation operates a ‘flexitime’ policy:

“We have core office hours which are 10–4 and then what time you actually come into your desk, in theory, is flexible, and what time you leave, as long as you’ve done your 37.5 hours a week and you’re in the office after four, is flexible.” (P12; female, 45–64, full-time, small)

Providing employees are in the office during ‘core’ hours, it is up to them how they fulfil their allocation of 37.5 hours a week. As described in Section 5.4.1.1, this flexibility was attributed to the fact that these organisations trusted their staff, or, at least, the staff perceived that they were trusted.

Participant 19, in their role as a community engagement officer for a small ‘health’ services organisation, often spent time working away from the office out in the community. They explain how they instinctively felt they needed to ‘check in’ with the organisation and how management responded:

“I still report in and they [management] say to me ‘why? You’re doing your time—as long as you do your hours, your job, that’s absolutely fine’. There’s no time sheet as such, no-one looking over your shoulder so there’s a lot of trust.” (P19; female, 25–44, full-time, small)

As this participant points out, management clearly trust staff to carry out their role without constant monitoring, which allows employees a significant degree of flexibility. Participant 3 suggests this makes for a “happier working environment” (P3; female, 25–44, part-time, micro).

As well as having temporal flexibility, some participants benefited from spatial flexibility. For example, those who were able to carry out their work from home were, if they wanted, able to do so. Participant 21, a male, full-time development associate, explains how he is able to work from home when carrying out certain tasks:

“There’s like a specific set of things that I prefer to do at home, where I can just kind of get on with it in kind of comfortable—they’re things that I hate doing, so I’d much rather be at home and have access to tea or be able to go for a walk and it not bother anybody else” (P21; male, 25–44, full-time, micro)

Rather than being obliged to come into the office, this participant has the flexibility to choose whether they would prefer to work from home or not when having to carry out tasks they find particularly difficult.

It was noted earlier, in Section 5.4.1.1, that employers were perceived as being flexible in adapting to employees’ specific requirements, such as Participant 3’s, who asked to work fewer days per week, which they cited as having a positive influence on their wellbeing. In this section, it has been shown that employers were also flexible regarding when employees came into, and left work, as well as where they did it. This is considered a determinant of ‘good’ work thought to positively impact upon health and wellbeing (Marmot et al., 2010), and findings from intervention studies show that improving employees’ control over start and finish times results in decreased tiredness (Kandolin et al., 1996); decreased systolic blood pressure (Viitasalo et al., 2008); and increased job satisfaction (Pryce et al., 2006). This is based on the premise that employees who set their own hours are able to ‘recover’ from the demands of work at a time convenient for them (Gervais, 2016). However, some interviewees actually cited this flexibility as a negative determinant of their health and wellbeing (see Section 5.4.2.2), therefore it cannot be assumed that the temporal and spatial flexibility that participants had would benefit all of them.

5.4.3.3. A culture of staff participation

Not only did employees report having control over their own work, they, generally speaking, felt able to exert influence on the organisation: they claimed that they were involved in decision-making processes, that their input was valued, and felt able to effect changes. For example, a lower-ranking male, full-time employee, Participant 17, who worked as a community engagement officer for a ‘health’ services organisation, describes how they were able to influence service delivery:

“I’ve been able to have quite an influence on the way the service is delivered which is nice ... For example, I had an idea that there’s not enough positive news in the world … So we created a brand called the ‘good newsagent’. When we go out we have sweet